<table width="100%" cellpadding="0" cellspacing="0">
	<tr>
		<td height="35" width="35" class="table1"></td>
		<td class="table2"></td>
		<td height="35" width="35" class="table3"></td>
	</tr>
	<tr>
		<td height="35" width="35" class="table4"></td>
		<td class="table5"><table border="0" cellpadding="0">
<tr>
<td>Одержувач відгуку</td><td>{receiver}</td>
</tr>
<tr>
<td>Текст</td><td><textarea name="message" style="width:450px; height:160px;"></textarea></td>
</tr>
<tr>
<td>Код захисту</td><td>{captcha}</td>
</tr>
<tr>
<td>Введіть код</td><td><input type="text" name="captcha" /></td>
</tr>
<tr>
<td colspan="2"><center><input type="submit" value="Надіслати" /></center></td>
</tr>
</table> </td>
		<td height="35" width="35" class="table6"></td>
	</tr>
	<tr>
		<td height="35" width="35" class="table7"></td>
		<td class="table8"></td>
		<td height="35" width="35" class="table9"></td>
	</tr>
</table>